Lasers in Medical Science

, Volume 33, Issue 7, pp 1485–1491 | Cite as

Comparative study using fractional carbon dioxide laser versus glycolic acid peel in treatment of pseudo-acanthosis nigricans

  • N. S. Zaki
  • R. F. HilalEmail author
  • R. M. Essam
Original Article


Pseudo-acanthosis nigricans is a common dermatological disorder that is usually difficult to treat secondary to maceration of the skin from excessive sweating, obesity, or associated with endocrine disorders. Fractional photothermolysis and chemical peeling have been reported to improve the condition. To determine whether fractional CO2 laser resurfacing or glycolic acid peel is more effective and safe option for therapy. Twenty Egyptian patients were included in the study where each patient was subjected to three sessions of both fractional CO2 on the right side of the neck and glycolic acid peel 70% on the left side of the neck. All patients were evaluated by a scoring system Acanthosis Nigricans Area and Severity Index (ANASI) score and three blinded dermatologists before and after treatment. Clinical improvement on the side treated by glycolic acid peel showed 43% improvement while the side treated by fractional CO2 showed 19% improvement. Glycolic acid peel shows superior results to fractional CO2 due to accelerated induced exfoliation, yet still fractional CO2 results are promising due to a presumably long-term improvement of skin texture.


Pseudo-acanthosis nigricans Acanthosis nigricans scoring system Glycolic acid peel Fractional CO2 laser 



We thank Professor Samia Esmat, Professor of Dermatology, Cairo University, for her help in final editing of the manuscript.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Barbato MT, Criado PR, Silva AK, Averbeck E, Guerine MB, Sá NB (2012) Association of acanthosis nigricans and skin tags with insulin resistance. An Bras Dermatol 87(1):97–104CrossRefPubMedGoogle Scholar
  2. 2.
    Phiske MM (2014) An approach to acanthosis nigricans. Indian Dermatol Online J 5(3):239–249CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Curth HO (1976) Classification of acanthosis nigricans. Int J Dermatol 15(8):592–593CrossRefPubMedGoogle Scholar
  4. 4.
    Burke JP, Hale DE, Hazuda HP, Stern MP (1999) A quantitative scale of acanthosis nigricans. Diabetes Care 22(10):1655–1659CrossRefPubMedGoogle Scholar
  5. 5.
    Bogdan Allemann I (2010) Fractional photothermolysis—an update. Lasers Med Sci 25(1):137–144CrossRefPubMedGoogle Scholar
  6. 6.
    Sharad J (2013) Glycolic acid peel therapy—a current review. Clin Cosmet Investig Dermatol 6:281–288CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Fabbrocini G, De Padova MP, Tosti A (2009) Chemical peels: what’s new and what isn’t new but still works well. Facial Plast Surg. 25(5):329–336CrossRefPubMedGoogle Scholar
  8. 8.
    Ichiyama S, Funasaka Y, Otsuka Y, Takayama R, Kawana S, Saeki H, Kubo A (2016) Effective treatment by glycolic acid peeling for cutaneous manifestation of familial generalized acanthosis nigricans caused by FGFR3 mutation. J Eur Acad Dermatol Venereol 30(3):442–445CrossRefPubMedGoogle Scholar
  9. 9.
    Zayed A, Sobhi RM, Abdel Halim DM (2014) Using trichloroacetic acid in the treatment of acanthosis nigricans: a pilot study. J Dermatolog Treat 25(3):223–225CrossRefPubMedGoogle Scholar
  10. 10.
    Wijnberg DS, Deutman HC, Steijlen PM, Spauwen PHM (2000) CO2 laser treatment of benign juvenile acanthosis nigricans. Eur J Plast Surg 23:238–240CrossRefGoogle Scholar
  11. 11.
    Campos MA, Varela P, Baptista A, Ferreira EO (2016) Unilateral nevoid acanthosis nigricans treated with CO2 laser. BMJ Case Rep 25:2016Google Scholar
  12. 12.
    Kutlubay Z, Engin B, Bairamov O, Tüzün Y (2015) Acanthosis nigricans: A fold (intertriginous) dermatosis. Clin Dermatol 33(4):466–470CrossRefPubMedGoogle Scholar
  13. 13.
    Jalaly NY, Valizadeh N, Barikbin B, Yousefi M (2014) Low-power fractional CO2 laser versus low-fluence Q-switch 1,064 nm Nd:YAG laser for treatment of melasma: a randomized, controlled, split-face study. Am J Clin Dermatol 15(4):357–363CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Dermatology, Kasr Al Ainy Teaching HospitalCairo UniversityCairoEgypt
  2. 2.Student HospitalCairoEgypt

Personalised recommendations